Provider Demographics
NPI:1629021308
Name:CUEVAS MARRERO, JAVIER (MD)
Entity Type:Individual
Prefix:DR
First Name:JAVIER
Middle Name:
Last Name:CUEVAS MARRERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JAVIER
Other - Middle Name:
Other - Last Name:CUEVAS MARRERO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:130 AVE WINSTON CHURCHILL
Mailing Address - Street 2:PMB 108
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6013
Mailing Address - Country:US
Mailing Address - Phone:787-755-0595
Mailing Address - Fax:
Practice Address - Street 1:130 AVE WINSTON CHURCHILL
Practice Address - Street 2:PMB 108
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-6013
Practice Address - Country:US
Practice Address - Phone:787-755-0595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13505208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics